Medical Director - Hospitalist

Job Summary

A company is looking for a Medical Claims Review Medical Director - Hospitalist - Remote.

Key Responsibilities

• Conduct coverage reviews and render coverage determinations based on member plan benefits
• Document clinical review findings in accordance with policies and regulatory requirements
• Engage in peer-to-peer discussions with requesting providers as needed

Required Qualifications

• M.D. or D.O
• Active unrestricted medical license with the ability to obtain additional state licenses
• Board certification in Internal Medicine, Family Medicine, or Emergency Medicine
• 5+ years of clinical practice experience as a hospitalist post-residency
• Proven understanding of Evidence Based Medicine (EBM)